Public Health Priorities

Dr Eric Crampton
Insights Newsletter
1 November, 2019

I often describe New Zealand as the Outside of the Asylum – the last sane place in a world going mad.

But just what should we make of New Zealand’s public health system?

Eloise Gibson this week reported hospital staff vaccination rates are either shockingly low, or unknown. The public health system neither knows nor cares that midwives and other health workers might infect children too young for vaccination.

You see, easily preventable highly contagious serious illnesses are simply boring and passé. If you vaccinate people, the problem is solved – and you have no further reason to bother people.

It’s the non-communicable diseases that public health really cares about. Those offer endless opportunities for hectoring people about their own behaviour. For cajoling. For berating. For nudging. And, finally, for shoving.

But only for shoving us, the hoi polloi.

Never for shoving the anointed class of medical professionals.

The government is set to ban popcorn from daycare centres because of choking risk. Seven choking cases since the start of 2016 apparently justifies a ban on small foods that the public health clerisy deems to have insufficient offsetting nutritional merit. Other edicts, in place or proposed by the public health crowd to protect us from our own consumption decisions, are not hard to find.

But the government will not require hospital workers to be vaccinated. Almost half of Waitemata DHB staff are not vaccinated against whooping cough, which can easily kill infants too young to be vaccinated – and no other DHB is even keeping track. Popcorn’s perils presumably pass pertussis’s.

Perhaps Medical Officers of Health are too busy with other priorities to worry about tallying hospital staff vaccination rates. They have important work to do preventing new bottle shops from opening and restricting the hours of existing ones.

The result is a system that leaps at the chance to protect patients from perilous sodas by banning their sale in every hospital, but powerless to protect them from the sneezes of unvaccinated staff.

Public health deems compulsion to be fine when telling all of us what to do, but not when it comes to hospital staff vaccination. Even getting doctors to wash their hands properly between patients seems too hard.

The incoherence of it all seems madness, if you think that health is the point of public health.

The true madness is deeper.

The true madness is that any of us put up with it.

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